Health Insurance Service-National Sample Cohort Research Articles

Long-Term Non-skeletal Complications in Patients with Thyroid Cancer and Hypoparathyroidism Post-total Thyroidectomy.

Thyroid cancer (TC) is a prevalent endocrine malignancy with rising incidence attributed to advancements in diagnostic technology. Despite its generally favorable prognosis, post-surgical complications, including hypoparathyroidism, can cause long-term health challenges. This study evaluated the risk of non-skeletal complications in TC patients with hypoparathyroidism. A retrospective cohort study was conducted using the National Health Insurance Service-National Sample Cohort (2002-2019), including TC patients diagnosed between 2006 and 2019. Participants were categorized into TC with hypoparathyroidism (TC with hypoP), TC without hypoparathyroidism (TC without hypoP), and matched controls. Propensity score matching and Cox proportional-hazards models evaluated the incidence and risk of non-skeletal complications, including diabetes mellitus, dyslipidemia, cardiovascular and renal outcomes, and cataracts. This study included 430 and 850 patients in the TC with hypoP and TC without hypoP groups, respectively, and their matched controls. The TC with hypoP group showed significantly higher risks of diabetes mellitus (HR 1.31, 95% CI: 1.01-1.68), dyslipidemia (HR 1.29, 95% CI: 1.06-1.57), urinary stones (HR 1.61, 95% CI: 1.00-2.57), and cataracts (HR 1.50, 95% CI: 1.15-1.95), compared to controls (all P<0.05). Hypertension risk was higher in the TC with hypoP group versus the TC without hypoP group (HR 1.39, 95% CI: 1.00-1.93, P=0.048). Women had higher urinary stone risk, while cataract risk increased in patients aged over 50. TC patients with hypoparathyroidism are at an increased risk for specific non-skeletal complications, particularly older adults and women. These findings underscore the need for targeted monitoring and management strategies in this population. Further prospective studies are warranted to validate these associations and elucidate the underlying mechanisms.

Adherence to Antidiabetic Medication and Cardiovascular Outcomes in Cancer Patients: A Nationwide Population-Based Cohort Study.

Cancer survivors increasingly face cardiovascular disease (CVD), with diabetes as a major risk factor. This study investigates the relationship between adherence to antidiabetic medications and cardiovascular (CV) outcomes in cancer patients. Using data from the Korean National Health Insurance Service-National Sample Cohort, we assessed the clinical outcomes of adult cancer patients prescribed antidiabetic medications. The study population was categorized based on medication adherence, as determined by the medication possession ratio (MPR): good (MPR ≥ 0.8), moderate (0.5 ≤ MPR < 0.8), and poor (MPR < 0.5) adherence. The primary outcomes included overall and CV mortality, with secondary outcomes encompassing hospitalization for major CVDs and healthcare costs. Among the 7928 cancer patients with diabetes, 59.7% were nonadherent (22.1% with moderate and 37.6% with poor adherence). Over a median follow-up of 5.7 years, 1462 deaths and 2897 CV events were confirmed. Multivariable adjusted analyses showed a 1.70-fold and 2.11-fold higher risk of overall mortality for the moderate and poor adherence groups, respectively, compared to the good adherence group. For CV mortality, moderate adherence was associated with a 1.51-fold higher risk, and poor adherence with a 2.10-fold higher risk. The risk for new-onset CV events increased by 1.32-fold in the moderate adherence group and 1.44-fold in the poor adherence group. The good adherence group also showed significantly lower total healthcare costs compared to the nonadherence group. The present study underscores the importance of adherence to antidiabetic medications in cancer patients, revealing significant associations with decreased mortality, CV events, and healthcare costs.

The effects of smoking, alcohol consumption, obesity, and physical inactivity on healthcare costs: a longitudinal cohort study

BackgroundResearch indicates major risk factors including smoking, alcohol consumption, obesity and physical inactivity contribute significantly to global disease burden and healthcare costs. However, these studies have challenges, such as increased bias and uncertainty arising from use of population attributable fractions (PAF) and the issue of reverse causality in cross-sectional data. This study aims to evaluate the long-term healthcare costs associated with these behaviors using a longitudinal cohort.MethodsThis longitudinal cohort study used the Korean National Health Insurance Service—National Sample Cohort database (NHIS-NSC 2.0), covering 2002–2019. The cohort included individuals aged 40–69 years who underwent health examinations in 2002–2004 and had no pre-existing risk factor-related diseases. Cumulative healthcare costs during 2010–2019 were analyzed using a generalized linear model with log-link function and gamma distribution, adjusted for other health behaviors and sociodemographic factors.ResultsSmoking, alcohol consumption, obesity, and physical inactivity significantly increased healthcare costs for both sexes. Male current smokers incurred 13.8% higher costs than never-smokers, while female smokers spent 18.6% more. Former smokers had lower costs than current smokers, with reductions of 9.9% for males and 13.2% for females. Almost daily alcohol consumption raised costs by 21.4% for males and 31.8% for females. Costs varied by BMI categories, with severe obesity increasing expenditures by 26.9% for males and 46.5% for females compared to normal weight. Overweight status showed contrasting effects between sexes, with a 3.4% decrease in healthcare costs for males but a 7.6% increase for females. Exercising 1–4 times weekly reduced costs by 7.6% for males and 7.4% for females compared to non-exercisers.ConclusionsThe study underscores the economic impact of health risk behaviors and supports the need for targeted public health interventions. The findings highlight the importance of targeted interventions for high-risk groups for reducing healthcare costs.

Regional Difference in the Association Between Long-Term PM and Cardiovascular Disease Incidence and Potential Determinants of the Difference.

While short-term studies of the adverse effects of air pollution have found regional differences, there has been insufficient evidence from long-term studies. This study investigated the spatial variation of the association between long-term exposure to particulate matter (PM) air pollution and cardiovascular disease (CVD) incidence and their relevant regional characteristics. We selected 155,017 adults who have lived over 13years in each of the 16 regions of South Korea from the National Health Insurance Service-National Sample Cohort. We assessed the individual long-term exposure as a 5-year average concentration at district-level residential addresses estimated by previously validated exposure prediction models. We applied time-dependent Cox-proportional hazard models to explore the spatial variation of long-term PM exposure's association with CVD incidence. After adjusting for individual-level characteristics, we estimated the region-specific hazard ratios (HRs) of incident CVD per 10μg/m3 increase in PM10 and PM2.5. Then, we calculated the correlation coefficients between region-specific HRs and 80 regional attributes in 13 categories across 16 regions to identify the related regional characteristics. Region-specific HRs of CVD incidence for PM showed considerable variation in magnitude and direction across 16 regions. HRs of PM10 and PM2.5 were higher in major urban areas and lower in rural areas. Urbanicity and emission sources exhibited significant correlations with HRs of overall CVD. Our findings offer an opportunity to explore regional characteristics that derive the difference in air pollution-associated health effects and help us provide guidance to target specific characteristics to avoid the adverse health effects of air pollution.

Trajectory Analysis in FBG and the Incidence of Chronic Kidney Disease: A Nationwide Population-Based Study.

This study aimed to classify fasting blood glucose (FBG) trajectories by sex and examine their associations with the risk of chronic kidney disease (CKD). Using data from the National Health Insurance Service-National Sample Cohort in Korea, participants aged 40 years and above, without CKD or diabetes mellitus (DM), were followed from 2002 to 2009. Based on their FBG trajectories, participants were categorized into two classes and stratified by sex. CKD incidence rates were analyzed according to these FBG trajectories, and the impact of additional risk factors on CKD incidence was assessed. A total of 91,131 participants were analyzed. Among individuals classified in Class 1, FBG levels gradually increased from 90.7 (men) and 88.7 (women) in 2002 to 96.6 (men) and 93.2 (women) in 2009. In contrast, participants classified as Class 2 exhibited a rapid increase in FBG levels, rising from 106 (men) and 106 (women) in 2002 to 144 (men) and 132 (women) in 2009. The incidence of CKD increased over time in both men and women classified as Class 2 compared to Class 1, with respective hazard ratios (HR) of 1.35 for men and 1.53 for women. Additionally, increased age, hypertension, and body mass index (BMI) were independently associated with an elevated risk of CKD. The Class 2 group demonstrated a significantly higher incidence of CKD compared to the Class 1 group. This finding indicates the need for the proactive management of individuals with relatively high FBG levels featuring rapid FBG increases in order to mitigate the risk of CKD development.

Association between long-term PM2.5 exposure and risk of infectious diseases - acute otitis media, sinusitis, pharyngitis, and tonsillitis in children: A nationwide longitudinal cohort study.

Association between long-term PM2.5 exposure and risk of infectious diseases - acute otitis media, sinusitis, pharyngitis, and tonsillitis in children: A nationwide longitudinal cohort study.

Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study.

The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group. This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006-2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated. Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures. In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Dynamic chronological changes of upper reference limits for liver enzymes in the nationwide population: the Korean National Health Insurance Service-National Sample Cohort 2002-2013.

Dynamic chronological changes of upper reference limits for liver enzymes in the nationwide population: the Korean National Health Insurance Service-National Sample Cohort 2002-2013.

Attributable Costs of Clostridioides difficile Infections in Korea.

Clostridioides difficile infection (CDI) is one of the most common hospital-acquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service-National Sample Cohort spanning a decade (2010-2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Association between acid-suppressive drugs and risk of psoriasis: retrospective study using Korean National Health Insurance Service-National Sample Cohort.

Psoriasis is a common inflammatory skin disorder following non-specific triggers. Involvement of immune system is widely accepted for pathogenesis studies have demonstrated importance of gut microbiota in pathogenesis of inflammatory skin diseases. Proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) are acid-suppressive drugs widely used for acid related gastrointestinal diseases, and prolonged use has been associated with altered gut microbiota. This study aimed to investigate association between psoriasis and acid suppressing drugs in Korean population. This study was conducted with 3,662 patients diagnosed with psoriasis between 2002 and 2013 in NHIS-NSC. A total of 14,648 controls were matched at 1:4 based on sex, age, and gastrointestinal disease. ORs were estimated to determine the association between acid suppressing drug use and psoriasis. Our study found a statistically significant association between the prolonged use of acid-suppressive drugs and the development of psoriasis in the Korean population. Specifically, patients with gastrointestinal diseases who used histamine-2 receptor antagonists (H2RA) or proton pump inhibitors (PPI) for extended periods exhibited a higher risk of developing psoriasis. The adjusted odds ratio for psoriasis was 1.89 (95% CI, 1.66-2.17) with long-term use, indicating a clear dose-response relationship. Results from our study indicate that prolonged use of H2RA or PPI is associated with the risk of psoriasis among patients with gastrointestinal diseases in Korean population. The risk was increased in dose-response trend after adjusting for confounding variables. Clinicians should be aware of risks associated with prolonged use of acid suppressing drugs.

Modifiable risk factors for early- and late-onset dementia using the Korean national health insurance service database.

Early-onset dementia (EOD) and late-onset dementia (LOD) may have distinct modifiable risk-factor profiles. To identify and compare factors associated with EOD and LOD using a nationwide cohort database. Nationwide two nested case-control studies. We used the National Health Insurance Service-National Sample Cohort database (2004-2019). The initial sample size was 514,866; 5157 EOD and 39,326 LOD cases were matched 1:1 with controls based on age, sex, and the Charlson Comorbidity Index. Socioeconomic status, residential area, body mass index, alcohol consumption, smoking status, physical activity, blood pressure, and laboratory findings were analyzed. Multivariable logistic regression models were used to identify the risk factors. Higher socioeconomic status and increased frequency of physical activity were associated with a lower risk of both EOD and LOD. Rural residence, heavy alcohol consumption, and higher fasting blood sugar levels were associated with an increased risk of LOD, although there was no significant association with EOD. Overall, these factors impacted LOD more strongly than EOD. Demographic and lifestyle factors had a greater effect on LOD than blood pressure and relevant laboratory findings. Modifiable risk factors were associated with LOD and EOD. The influence of some modifiable risk factors was more pronounced in the LOD group than in the EOD group. Identifying modifiable risk factors associated with dementia can aid in the development of preventive strategies, underscoring the clinical importance of our findings.

Rosacea and Its Potential Role in the Development of Irritable Bowel Syndrome: Insights From the Korean National Health Insurance Service-National Sample Cohort

Rosacea and Its Potential Role in the Development of Irritable Bowel Syndrome: Insights From the Korean National Health Insurance Service-National Sample Cohort

Cardiovascular Complications, Kidney Failure, and Mortality in Young-Onset Type 1 and Type 2 Diabetes: Data From the Korean National Health Insurance Service.

To explore all-cause mortality and the incidence of cardiovascular and renal complications among patients with young-onset diabetes in South Korea using a nationwide registry database. Data were collected from the Korean National Health Insurance Service-National Sample Cohort database from 2006 to 2019 for patients aged ≤30 years with type 1 diabetes (T1D) or type 2 diabetes (T2D). The incidence rates of cardiovascular complications (myocardial infarction [MI] and stroke) and kidney failure, as well as all-cause mortality, were compared with those in the general population. This study included 513,633 participants, comprising 413 with T1D, 1,250 with T2D, and 511,970 control individuals. After adjusting for sex, age, family income, hypertension, and dyslipidemia, the hazard ratio (HR) for MI was 6.76 (95% CI 2.44-18.72) and 5.07 (95% CI 2.48-10.36) for T1D and T2D, respectively. The HR for stroke was 4.65 (95% CI 1.70-12.71) and 3.30 (95% CI 1.67-6.53) for T1D and T2D, respectively. The HR for kidney failure was 20.92 (95% CI 11.40-38.39) and 2.78 (95% CI 1.37-5.64) for T1D and T2D, respectively. The mortality risk was significantly higher in patients with T1D (3.69; 95% CI 1.95-6.98) and T2D (3.06; 95% CI 2.02-4.63) than in the control group. The mortality risk was highest in the T2D subgroup of participants aged <20 years at enrollment (10.70; 95% CI 4.41-25.94). In South Korea, patients with young-onset diabetes are at high risk of cardiovascular complications, kidney failure, and death.

Effectiveness of Bisphosphonates in Young Adults with Fragility Fractures: Representative Population-Based Cohort Study.

Fragility fractures in young adults present significant clinical challenges due to the limited evidence on the effectiveness of bisphosphonates in preventing subsequent fractures. To evaluate the effectiveness of bisphosphonate therapy in reducing the fracture risk among premenopausal women with a history of osteoporotic fractures. A population-based retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in South Korea, covering the years 2003 to 2014. A nationwide healthcare setting utilizing a representative cohort database. Among 2,087 premenopausal women with osteoporotic fractures, participants were propensity score-matched based on age and body mass index at a 1:3 ratio, resulting in 132 bisphosphonate users and 396 non-users. Bisphosphonate treatment. The incidence of osteoporotic fractures. Bisphosphonate users had a significantly lower risk of major osteoporotic fractures (HR 0.618, 95% CI 0.396 - 0.963) compared to non-users. Ibandronate users showed significant reductions in both major osteoporotic (HR 0.376, 95% CI 0.164 - 0.861) and nonvertebral fractures (HR 0.214, 95% CI 0.052 - 0.877). Also, longer duration of bisphosphonate use (≥180 days) was associated with a significantly lower risk of major osteoporotic and nonvertebral fractures (HR 0.528, 95% CI 0.300 - 0.929; HR 0.409, 95% CI 0.187 - 0.895, respectively). Bisphosphonate therapy significantly reduces fracture risk in premenopausal women with previous osteoporotic fractures, especially at higher cumulative doses. These findings support considering bisphosphonates as a treatment option in premenopausal women at high risk of fractures.

Association between gastroesophageal reflux disease and tinnitus in a nationwide population-based cohort study

Gastroesophageal Reflux Disease (GERD) is characterized by the regurgitation of stomach contents. Recent research indicates that acid reflux may disrupt the homeostasis of the middle and inner ear through the Eustachian tube. Given this context, we hypothesized that an association between GERD and tinnitus may exist due to the imbalance of the middle and inner ear caused by acid reflux. To explore this connection, we conducted a retrospective cohort study involving 669,159 patients registered in the National Health Insurance Service-National Sample Cohort (2012–2019) in South Korea. Our data showed that GERD and tinnitus are highly associated. Nevertheless, the use of proton pump inhibitor medication in GERD patients did not show a significant decrease in the onset of tinnitus.

Impact of regional medical self-sufficiency on mortality from cancer, stroke and myocardial infarction

ObjectivesThis study aimed to explore the impact of regional medical self-sufficiency on mortality from cancer, stroke and myocardial infarction (MI), and make policy suggestions to address regional health disparities and promote national health outcomes. Study designA multilevel analysis of nationwide data. MethodsThis study employed the Korean National Health Insurance Service-National Sample Cohort database at the individual level and the Korean Medical Utilization Statistics at the regional level. The study population included 31,862 individuals who were newly diagnosed with cancer, 16,793 with stroke and 2936 with MI between 2011 and 2019. Multilevel logistic regression was used to address the clustered structure of regional-level data with individual-level data on demographics and health details nested within it. ResultsRegional medical self-sufficiency did not significantly impact 1-year mortality in cancer patients. For patients with stroke and MI, a low level of medical self-sufficiency in the residential area was associated with a notably increased likelihood of dying within 1 month by 1.03 (95 % confidence interval [CI]: 1.02–1.07) and 1.44 (95 % CI: 1.08–2.01) times, respectively. Stratified analysis by region of residence showed that even if cancer patients lived in Seoul and metropolitan areas, they had an increased risk of death within 1 year if the medical self-sufficiency of their treatment areas was low (adjusted odds ratio [aOR]: 1.19, 95 % CI: 1.03–1.38). Moreover, for patients with MI living in medically underserved areas, the risk of death tended to increase with lower income. ConclusionsThe findings demonstrated that for acute stroke or MI patients, living in areas with low self-sufficiency of medical care had a higher likelihood of dying within 1 month. To improve national health outcomes and address regional medical disparities, it is crucial to prioritise policies such as establishing specialised centres dedicated to managing acute cardio-cerebrovascular conditions in each region.

Prevalence of and risk factors associated with chronic opioid use after traumatic injury: A historical cohort study using the Korean National Health Insurance Service sample cohort data.

Chronic opioid use (COU) after traumatic injuries is a global health concern. COU after trauma delays recovery and increases the risk of long-term drug dependence. However, the population-prevalence and factors associated with COU after traumatic injury in South Korea remain unclear. We aimed to estimate the prevalence of COU and associated risk factors in patients after trauma in South Korea. A historical cohort study using the population-representative database including 1,103,405 South Korean subjects, patients admitted due to a newly diagnosed trauma (n = 65,444) or nontraumatic etiologies (n = 338,321) from January 1, 2003, to June 30, 2015, were analyzed. COU was defined as the prescription of opioid in the first 3 to 6 months from the index date. Prevalence of COU was summarized. A multivariable logistic regression analysis was conducted to investigate association of COU with traumatic injuries, accounting for a priori sociodemographic and clinical risk factors. A total of 13.5% and 12.6% of patients were found to be chronic opioid users in the trauma and the control group, respectively. The adjusted odds ratio (aOR) (95% CI) of COU in the injured compared to the noninjured was 1.13 (1.01 to 1.16), when controlling for age group, sex, calendar year, area of residence, previous opioid use, comorbidity, surgery during the index admission and intensive care unit care. Risk factors included being aged 65 to 74 years (aOR = 2.87; 95% CI = 2.73 to 3.01), aged ≥ 75 years (aOR = 2.48; 95% CI = 2.35 to 2.62), and history of previous opioid use (aOR = 3.27; 95% CI = 3.21 to 3.34) were the most significant risk factors of COU, independent of injury. COU was prevalent both in the injured and noninjured patients, with slightly increased risk of COU in those sustaining traumatic injury compared to those who were noninjured. Further stud y to address prevalent COU in South Korea is required to avoid opioid-related harms.

Sex Differences in Clinical Features in Gout: A Nationwide Retrospective Cohort Study.

Background: Patients with gout have several coexisting conditions that impact mortality. We analyzed the differences in clinical manifestations among Korean patients with gout and compared the causes of death based on sex using data from the Korean National Health Insurance Service-National Sample Cohort database. Methods: We included adults with gout receiving urate-lowering therapy (ULT) from 2002 until 2019. The clinical features and causes of death were compared between male and female patients. Multivariate Cox regression was performed to identify the risk factors contributing to all-cause mortality. Results: The results showed that female patients were older at the start of ULT and had more comorbidities. The most common cause of death among all patients with gout was chronic kidney disease (CKD). When observed separately by sex, lung cancer is the leading cause in males, versus CKD in females. Multivariate Cox analysis showed that old age at ULT start, low body mass index (BMI), current smoking, diabetes, CKD, cerebrovascular disease, malignancy, and low hemoglobin were significant risk factors for all-cause mortality in males; however, old age at ULT start, low BMI, CKD, malignancy, and low hemoglobin were significant risk factors in females. Conclusions: The clinical features and cause of death were different between male and female patients with gout, suggesting that treatment strategies for gout should be established differently depending on sex.

Association Between Atopic Dermatitis and Meniere's Disease: Nationwide Cohort Study.

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by relapsing and remitting episodes. Although AD is well-known for its association with other allergic conditions, its relationship with Meniere's disease has not been thoroughly investigated. This study aimed to explore the potential correlation between AD and Meniere's disease. This study utilized data from the National Health Insurance Service-National Sample Cohort, a nationwide population-based database. The AD group was selected from a cohort of 1 million individuals randomly extracted from database. A non-AD group was obtained through Propensity Score Matching. The AD group comprised 84,579 individuals, with an equal number of individuals in the non-AD (control) group. The overall hazard ratio (HR) for Meniere's disease in the AD group was 1.44 (95% confidence interval (CI): 1.31-1.6). Subgroup analysis showed an adjusted HR of 0.42 (95% CI: 0.38-0.48) for Meniere's disease in males, 4.99 (95% CI: 4.45-5.62) in the middle-aged group (40-59 years), and 8.21 (95% CI: 7.21-9.35) in the older age group (≥60 years). Additionally, the adjusted HRs for developing Meniere's disease were higher in patients with comorbidities, including allergic rhinitis (1.18 [95% CI, 1.07-1.32]), allergic contact dermatitis (1.32 [95% CI, 1.19-1.48]), and allergic conjunctivitis (1.54 [95% CI, 1.32-1.82]). Long-term follow-up revealed that the prevalence of Meniere's disease was 1.44 times higher in the AD group compared to the control group. Moreover, older age, female sex, allergic rhinitis, allergic contact dermatitis, and allergic conjunctivitis were identified as factors that increase the risk of developing Meniere's disease. 3 Laryngoscope, 2024.

Fraction of Cancer Attributable to Carcinogenic Drugs in Korea from 2015 to 2030.

This study aims to estimate and project the Population Attributable Fraction (PAF) of cancer incidence and death due to carcinogenic drug use in Korea from 2015 to 2030, to estimate the degree of cancer prevention from exposure to carcinogenic drugs in Korea. Selected carcinogenic drugs were immunosuppressive and antineoplastic drugs classified as group I by the International Agency for Research on Cancer (IARC). Systematic review and meta-analyses were conducted to estimate the relative risk (RR) of cancer associated with carcinogenic drug use. Age was standardized using the annual prevalence rate of the National Health Insurance Service sample cohort (NHIS-NSC) from 2002 to 2013 to calculate the standardized prevalence rate of carcinogenic drug use each year. The PAF of specific cancer incidence and death were calculated using Levin's formula and Monte Carlo methods. The prevalence rates were extrapolated to estimate the trend of PAF from 2015 to 2030. In 2015, carcinogenic drugs attributed to 0.003% and 0.002% among the causes of cancer incidence and death in Korea. However, carcinogenic drugs attributed to 1.1% among the causes of both cancer incidence and death in patients with clinical indications of carcinogenic drugs. The PAF in patients with clinical indications of carcinogenic drugs were significantly high and expected to increase rapidly over time. Since these drugs are listed as essential by the World Health Organization (WHO), and may be difficult to replace, a surveillance system on susceptible populations using group I carcinogenic drugs must be discussed and implemented.